title: Development and validation of a discharge planning index for achieving home discharge after hospitalization for acute stroke among those who received rehabilitation services.
abstract: OBJECTIVE
  The aim of this study was to develop an index for establishing the probability of being discharged home after hospitalization for acute stroke using information about previous living circumstances, comorbidities, hospital course, and the physical grades and cognitive stages of independence achieved.
  
  
  METHODS
  This is a longitudinal observational population-based study. All 6515 persons treated for acute stroke who received rehabilitation services in 110 Veterans Affairs facilities within a 2-yr period were included.
  
  
  RESULTS
  There were eight independent predictors of home discharge identified, and points were assigned through logistic regression: married (2 points); location before hospitalization (extended care = 0 points, other hospital = 9 points, home = 11 points); discharge physical grade (grade I, II, or III = 0 points; grade IV or V = 3 points; grade VI or VII = 5 points); discharge cognitive stage (stage I = 0 points; stage II, III, IV, or V = 3 points; stage VI or VII = 5 points); and absence of liver disease (2 points), mechanical ventilation (3 points), nonoral feeding (2 points), and intensive care unit admission (1 point). The points were added for all present factors to calculate scores. The probabilities of home discharge ranged from 65.03% in the least likely (≤21 points) to 98.24% in the most likely group (≥27 points).
  
  
  CONCLUSIONS
  The treatment team might apply prognostic estimates from this index in discharge planning and functional goal setting after initial physical medicine and rehabilitation assessment.
authors.affiliation: From the Center for Clinical Epidemiology and Biostatistics (MGS, PLK, JEK, DX) and Department of Physical Medicine and Rehabilitation (MGS), University of Pennsylvania, Philadelphia; Veterans Affairs Medical Center, Albany, New York (BEB); Physical Medicine and Rehabilitation, Albany Medical College, New York (BEB); VA HSR&D/RR&D Rehabilitation Outcomes Research Center, REAP North Florida/South Georgia Veterans Health System, Gainesville, Florida (DCR); and Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville (DCR).
authors.forename: Margaret G
authors.initials: MG
authors.lastname: Stineman
authors.forename: Pui L
authors.initials: PL
authors.lastname: Kwong
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Bates
authors.forename: Jibby E
authors.initials: JE
authors.lastname: Kurichi
authors.forename: Diane Cowper
authors.initials: DC
authors.lastname: Ripley
authors.forename: Dawei
authors.initials: D
authors.lastname: Xie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000458:organization & administration*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010348:Patient Care Team / Q000458:organization & administration; D010351:Patient Discharge / Q000592:standards*; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D018570:Risk Assessment; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome